Measures of physical restraint in the hospital

In general, measures of restraining physical freedom are considered to be inadmissible in the hospital setting. However, there is both an ethical and legal consensus that they can be necessary in situation of patients endangering themselves or others. The Swiss Civil Code imposes narrow criteria of assessing the necessity of these measures, introducing them, measuring their effectiveness and suspending them as soon as possible. Together with the Nursing Department and the Nursing Research Unit of the University Hospital, the Clinical Ethics Unit has contributed to develop the documentation in the electronic patient chart that addresses both the ethical and legal aspects. In an ongoing internal project, the data of the first year since the introduction of the new documentation will be evaluated by analyzing both the frequency and the localization as well as patient-specific patterns. The goal is to gather insights about environmental factors that may influence the introduction of these measures, raise the awareness of the team for these factors, identify patients particularly vulnerable for measures of physical restraint and develop strategies to prevent them.